For appointments: 1 203 661 7546|40 West Elm Street, Greenwich CT 06830
For appointments call 1 203 661 7546

Scars

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What are the signs or symptoms of a scar?

Scars come in an infinite variety depending on location, shape, age, origin and skin type. Some scars are just skin deep, others carry an emotional burden. Some like to flaunt their scars, most would just rather never have to look at them. There are different types of scars.

In general, self-harm scars and other fresh traumatic and surgical scars or wounds tend to be more amenable to treatment than others. The same goes for stretch marks and acne scars. Keloids are traditionally the most resistant to scar treatment.

Treatment options

Linear flat red scars:

Pulsed Dye Laser (PDL) to clear the red color
Fraxel Re:store (FXL-R) to resurface skin texture

Linear raised red scars:

• from facelifts, breast surgery, abdominoplasty, cancer sx
UltraPulseCO2 laser for flattening
Pulsed dye laser for the red color
Fraxel Re:pair for retexturing
• Silicone gel sheets to enhance or maintain flattening

Linear white scars:

Fraxel Re:store or Fraxel Re:pair

Acne scars:

• Ice pick acne scars; punch excision + Fraxel Re:store
• Boxcar acne cars, dermabrasion, also seen in chickenpox scars, do well with punch elevation (cutting out the base and elevating the scar) or subcision (severing all the attachments under the scar) + filler to keep the scar elevated followed by FXL resurfacing
• Atrophic and undulating acne scars respond well with the Fraxel Re:store or Fraxel Re:pair resurfacing and Sculptra injections to restore fullness of skin

Hypertrophic scars:

These are due to excessive collagen deposition. As opposed to keloids, these scars remain confined to the area of injury and surrounding skin, usually flattening out within 18 months. The scar tissue responds beautifully to Fraxel Re:store treatments.

Keloids:

Keloid scars develop more likely in darker skin types, over joints and breastbone in lighter skin types and when the scar goes against the grain of the skin. They also are due to excessive deposition of collagen, but these scars typically extend beyond the part of the body of injury and never disappear. Keloids hurt, itch, contract, pull and disfigure. Patience is of primordial importance when dealing with keloids. They are notoriously fickle in their response to treatment, especially if too aggressive. The research has shown that keloids respond best to CO2 lasers powerful enough to traverse the entire thickness of the lesion (=high energy) but used at minimal density (5%) and longer inter treatment intervals.

In the past, keloids were traditionally injected with high concentration cortisone to suppress their growth. Unfortunately, they also created a thinning and a depression of the skin surrounding the keloid. We therefore only use 5 fluoro-uracil for that purpose because it does not cause atrophy. Local Botox injections have been hugely helpful as well.

• Burn scars
• fresh or mature: Fraxel Re:store laser, preferably while still early
• Scars due to self-mutilation and hesitation marks from attempts at wrist slicing are best treated with the Fraxel Re:store laser while still fresh.

Natural Part of the Healing Process

Scar removal, when done properly, can yield natural looking results. Pigmentation can be restored and the scar effectively can go away, or at the very least go into permanent hiding.

Our goal is to blend the affected areas into the surrounding skin to eliminate the anxiety riddled visuals you may have had over your scars.

Scar therapy is achievable without skin grafts in many cases, with minimal side effects aside from minor inflammation. If pain persists, relief can be had through home remedies, ointments, creams, and other safe treatments.

Frequently Asked Questions

Sunken scars are recessed into the skin, often due to the skin being stuck to more internal structures like muscles. This could involve removing the original scar and then fixing the wound and nerves around it.

The goal of a scar revision procedure is to mute the appearance of a scar, regardless of dark skin or light skin types.

Atrophic scar is an indented scar that heals underneath the normal layer of skin. These scars form most commonly following a bout of acne.